Hi,
I specialize in creating custom-made, interactive PDF form (from an existing layout), including all of the scripts required to make it work perfectly. Do you have the layout designed already, or do you want this form created from scratch, though? If the latter I'm your man for the job, and I can start working on it right away.
A little bit about me: I'm an Expert on both the Adobe and AcrobatAnswers forums and have a website dedicated to my custom-made tools for PDF files that you're welcome to check out (Google my handle-name to find it).
You're also welcome to check out my work history on this site and see some of the PDF-related projects I've worked on in the past.
Regards, Gilad (try67)